title: Change in stress and social support as predictors of cognitive decline in older adults with and without depression.
abstract: OBJECTIVE
  The relationship between stress, social support, and cognition in geriatric depression is complex. In this study, we sought to examine whether an increase in stressful life events or a decrease in social support would lead to subsequent cognitive decline among older adults with and without depression.
  
  
  METHODS
  The sample consisted of 112 depressed and 101 non-depressed older adults who enrolled in the Neurocognitive Outcomes of Depression in the Elderly (NCODE) study. Participants were assessed clinically, agreed to interviews focusing on stressful life events and social support, and underwent a battery of neuropsychological tests annually. Our global measure of cognition was the Consortium to Establish a Registry in Alzheimer's disease Total Score (CERAD TS).
  
  
  RESULTS
  We found that a decline in the total number of stressors was associated with a subsequent improvement on CERAD TS. In terms of social support, decreased social interaction, and instrumental social support predicted decline in cognitive performance. These relationships were significant even after controlling for depression status, age, education, and sex.
  
  
  CONCLUSIONS
  These findings extend prior research on the importance of social factors in aging and depression which have largely focused on mood-related outcomes. Future confirmatory studies are needed. In addition, biological and other studies should be conducted to further our understanding of the relationship between stress, social support and cognition in older adults with and without depression.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: Whitney J
authors.initials: WJ
authors.lastname: Dickinson
authors.forename: Guy G
authors.initials: GG
authors.lastname: Potter
authors.forename: Celia F
authors.initials: CF
authors.lastname: Hybels
authors.forename: Douglas R
authors.initials: DR
authors.lastname: McQuoid
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012944:Social Support; D013315:Stress, Psychological